| NPI | 1184105389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 60921) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2023-04-27 |